1. Field of the Invention
The present invention relates to methods, systems and computer program products for generating an electronic bill having optimized insurance claim items.
2. Background Art
Currently, oncology physicians record the services for the treatment of a patient on a paper checklist. This paper is often called an: Encounter Form; a Superbill; or, in the case of hospital and office examination visits, a Face Sheet. These items are checked off and blanks are filled in to record the therapy and services provided during a patient visit. The sheets of paper tend to be incomplete and prone to errors. They are passed on to human medical billers specialized in oncology billing, who translate the information into a series of medical codes and billing quantities in order to obtain reimbursement from insurance carriers. The codes and requirements change frequently and vary significantly among the different carriers. The ordering of these codes obtain affects timely reimbursement.
The U.S. patent to Rensimer et al. (U.S. Pat. No. 6,154,726) discloses a system that allows the ability to record, transfer, or save medical data from a portable system to a database system. Also disclosed is a means of archiving patient information and generating clinical status codes that can be used for reimbursements from insurance companies.
The U.S. patent to Evans (U.S. Pat. No. 6,347,329) discloses a system comprising    a pen-based portable computer with wireless access to electronic patient records. The system may incorporate legacy files, such as paper files, from a patient's chart.
The U.S. patent to Gilbert (U.S. Pat. No. 6,381,576 B1) discloses a database program employing diagnostic and treatment information data structure that contains both clinical and financial information permitting effective filtering and analysis of Current Procedural Technology (CPT) codes as to accuracy and appropriateness.
The U.S. patent application publication to Porterfield (2002/0077854) discloses a system for determining the best possible billing scenario, in order to maximize reimbursements.
The U.S. patent application publication to Ibok et al. (2002/0116219) discloses a method for wireless accessing a medical record via a PDA, laptop, personal computer (PC) or other telephony device. Also disclosed is a method for secure information transmission using an authentication scheme. The system also includes an interface with existing legacy information.
U.S. patent application publication 2003/0074228 discloses an electronic medical record that is directed towards use in chemotherapy applications.
Electronic medical records in billing scenarios are shown by the following U.S. patents and publications: U.S. Pat. Nos. 6,223,164; 6,655,583; 2002/0091540; 2002/0120466; 2003/0083903; 2004/0204961; 2004/0199404; 2004/0128163; 2002/0123907; 2002/0087358; and 2002/0022972.